500 - SLEEEPSMART: A Shared-Management Web-Based Intervention for Sleep Deficiency in School-Age Children with Juvenile Idiopathic Arthritis and their Parents: Feasibility and Acceptability Study

Publication Number: 500.6865

Teresa M. Ward, University of Washington, Dept of Pediatrics, School of Medicine, Seattle, WA, United States; Shumenghui Zhai, Pacific Lutheran University, seattle, WA, United States; Tonya Palermo, Seattle Children's, Seattle, WA, United States; Susan Shenoi, Seattle Children's, Seattle, WA, United States

Background: Sleep deficiency is comorbid in Juvenile Idiopathic Arthritis (JIA) yet is not assessed in primary or rheumatology care. Of the few technology-based sleep interventions most target parents, and few include school-age children and parents in the design and development of the intervention.

Objective: To describe the feasibility, acceptability, and preliminary efficacy of a pilot randomized controlled trial of a sleep health intervention (SLEEPSMART) for children with JIA and their parents.

Design/Methods: Fifty children, 8-13 years, with JIA and sleep deficiency, and their parents participated in the pilot RCT study. Children and parents were randomized to SLEEPSMART or usual care. The SLEEPSMART intervention lasted 7-weeks and included weekly educational modules, quizzes, goal setting, and an online sleep coach. Children wore actigraphy and completed sleep diaries and surveys at baseline (T1), immediately post-intervention (T2), and one-month post-intervention (T3). Feasibility was measured by the percentage of eligible, enrolled, and retained dyads, engagement was measured when dyads completed the modules, and usefulness and acceptability were measured with the Treatment Evaluation Inventory and qualitative interviews. Preliminary efficacy on primary outcomes included actigraphy total sleep time, sleep efficiency, self-report PROMIS sleep disturbance, PROMIS sleep-related impairment, and secondary outcomes included self-efficacy measures.

Results: Of the 50 child-parent dyads enrolled, 88% completed the baseline assessment. Seventy-five percent of children and 89% of parents reported high acceptance; 89% of parents and 80% of children would recommend SLEEPSMART. Compared to children in the control group, children who received the SLEEPSMART intervention had significant improvements in actigraphy total sleep time, sleep efficiency. Children in the SLEEPSMART group also had significant improvements in their dysfunctional beliefs and attitudes about sleep and sleep efficacy scores one-month post-intervention. Parents in the SLEEPSMART group had significant improvements in the PROMIS sleep-related impairment and dysfunctional beliefs and attitudes about sleep scores immediately post-intervention and one-month follow-up; and in their self-efficacy scores one-month post intervention in comparison to parents in the control group.

Conclusion(s): SLEEPSMART was feasible, acceptable, and improved objective and self-report sleep and self-efficacy outcomes in children with JIA and their parents. This pilot RCT addressed current gaps and will be revised based on participant feedback to inform a larger multisite trial.